Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1033768551 |
---|---|
Provider Name | Jose Luis Torres |
First Address | Kissimmee, FL 34741-7569 |
Second Address | Orlando, FL 32807-1424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2019 |
Last Update Date | 06/09/2019 |